Individual
ENMANUEL MATOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMHC
Contact information
Practice address
652 GEORGE WASHINGTON HWY, LINCOLN, RI 02865-4330
(401) 475-9979
Mailing address
12 EAGLE ST UNIT 12-412, PROVIDENCE, RI 02908-5657
(401) 475-9979
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30343
BLUE CROSS CRISIS
RI
Enumeration date
06/01/2007
Last updated
03/20/2026
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